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General NPI Number Information
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NPI Number | 1831331883
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Entity Type | Organization
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Legal Business Name | MORRIS SENIOR LIVING
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Dates
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Enumeration Date | 04/06/2009
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Last Update Date | 04/06/2009
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Provider Practice Location Address
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Address Line | 1221 EDGEWATER DR
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City | MORRIS
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State | IL
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Zip | 60450-2504
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Country | US
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Telephone | 815-416-6200
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Fax | 815-416-6201
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Provider Business Mailing Address
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Address Line | 1221 EDGEWATER DR
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City | MORRIS
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State | IL
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Zip | 60450-2504
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Country | US
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Telephone | 815-416-6200
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Fax | 815-416-6201
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Authorized Official
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Title or Position | MANAGER
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Name | PHILOMENA MERRITHEY
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Credential |
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Telephone | 815-416-6200
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 310400000X
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Taxonomy Name | Assisted Living Facility
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License Number |
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License Number State | IL
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